Pain after Spine Surgery

Is It Normal to Have Back Pain a Year after Surgery?

Question:I had posterior lumbar interbody fusion surgery for a herniated disc at L4-L5 about a year and a half ago, but I'm still in horrible pain. The surgeon used pedicle screws, which don't really bother me, but my pain is worse now than it was before my surgery. I'm only 45, so I'm very worried that I'll have to live with this pain for the rest of my life. Is this common? Will I need another surgery?
—Highland Park, IL

Answer: Yes, some back pain after spine surgery is common. However, having pain a year and a half after your surgery isn't. Whether you'll need another surgery depends on several factors, including the severity of your pain and if the cause of your pain was fully addressed in your first surgery.

Pain is usually your body's way of telling you that something's not right. But pain is very individual, which means that the same type of pain may feel different to different people.

As a surgeon, I never tell a patient they don't have pain. However, sometimes I tell a patient that I don't have an immediate solution for his or her pain.

In your case, another surgery is not necessarily the answer. But ongoing pain usually requires further evaluation, which starts with a doctor's appointment.

At this appointment, your doctor will do a thorough evaluation to determine possible causes for your persistent pain. It could be that the fusion has not healed sufficiently, for example.

Another possibility is that the first surgery didn't fully address the underlying cause of your pain.

This evaluation will most likely include:

a review of your pain and treatment history

a physical exam

an x-ray, computed tomography (CT) scan, or a magnetic resonance image (MRI) to see if your fusion has healed or to detect other abnormalities

From here, your doctor may be able to identify the source of your pain, and how you treat it is a decision that you and your doctor should make together.

If you decide not to have another surgery, the good news is that some non-surgical treatments (eg, physical therapy) can help you cope with your pain.

Also, eating a healthy diet and getting regular physical activity can help reduce stress and improve your mood, which can ultimately ease your back pain.